Assessment of the Effectiveness of DWI-ASPECTS in Predicting the Functional Outcomes of Cerebral Infarction Patients After Thrombolysis

The aim of our study was to assess the effectiveness of the diffusion-weighted MRI imaging Alberta Stroke Program Early CT score (DWI-ASPECTS) system in predicting the long-term prognosis of cerebral infarction patients after intravenous thrombolysis. A total of 258 acute anterior circulation cerebral infarction patients treated with intravenous thrombolysis were enrolled in this study. The patients were divided into two groups according to their 3-month mRS scores. Patients with mRS scores of 0-2 were placed in the favorable outcome (F) group, and patients with mRS scores of 3-6 were placed in the unfavorable outcome (U) group. The clinical information and MRI findings of the two groups were compared. Results of the fifty-two admitted patients, thirty-six (69.2%) were included in the F group, and sixteen (30.8%) were included in the U group. The U group was characterized by older, predominantly female patients with shorter onset to MRI times, higher initial NIHSS scores, higher rates of prior antithrombotic therapy, and lower DWI-ASPECTS scores than the F group. The independent predictors of functional outcome included age, NIHSS, prior antithrombotic therapy, and ASPECTS score. According to the ROC curve analysis, the area under the ASPECTS score curve was approximately 0.878 (95% CI 0.784-0.971). The optimum ASPECTS score for predicting unfavorable outcomes was equal to 6.50, with a sensitivity and specificity of 77.8% and 81.3%, respectively. The Spearman correlation test results indicated that the DWI-ASPECTS scores were positively associated with the EQ-5D effect values and EQ-VAS values, with r values of 0.60 and 0.53, respectively (P = 0.000). DWI-ASPECTS could be used to accurately predict the functional outcomes of acute cerebral infarction patients after thrombolysis.